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Pulmonary hypertension in systemic lupus erythematosus: an independent predictor of patient survival

BACKGROUND/AIMS: We investigated whether transthoracic echocardiography-suspected pulmonary hypertension (PH) affects survival in systemic lupus erythematosus (SLE) patients and examined factors associated with PH occurrence and survival. METHODS: This retrospective single-center study included 154...

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Autores principales: Min, Hong Ki, Lee, Jae Ho, Jung, Seung Min, Lee, Jennifer, Kang, Kwi Young, Kwok, Seung-Ki, Ju, Ji Hyeon, Park, Kyung-Su, Park, Sung-Hwan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Association of Internal Medicine 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4351331/
https://www.ncbi.nlm.nih.gov/pubmed/25750566
http://dx.doi.org/10.3904/kjim.2015.30.2.232
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author Min, Hong Ki
Lee, Jae Ho
Jung, Seung Min
Lee, Jennifer
Kang, Kwi Young
Kwok, Seung-Ki
Ju, Ji Hyeon
Park, Kyung-Su
Park, Sung-Hwan
author_facet Min, Hong Ki
Lee, Jae Ho
Jung, Seung Min
Lee, Jennifer
Kang, Kwi Young
Kwok, Seung-Ki
Ju, Ji Hyeon
Park, Kyung-Su
Park, Sung-Hwan
author_sort Min, Hong Ki
collection PubMed
description BACKGROUND/AIMS: We investigated whether transthoracic echocardiography-suspected pulmonary hypertension (PH) affects survival in systemic lupus erythematosus (SLE) patients and examined factors associated with PH occurrence and survival. METHODS: This retrospective single-center study included 154 Korean SLE patients fulfilling the American College of Rheumatology criteria (January 1995 to June 2013). Student t test, Mann-Whitney U test, Kaplan-Meier curves, and log-rank tests were used for comparisons. RESULTS: A total of 35 SLE patients with PH (SLE/PH+) and 119 without PH (SLE/PH-) were analyzed. Higher percentages of interstitial lung disease, Raynaud's phenomenon (RP), World Health Organization functional classification III/IV, and cardiomegaly were found in SLE/PH+ compared to SLE/PH-. Furthermore, the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index was significantly higher in SLE/PH+ (2.46 ± 1.245 vs. 1.00 ± 1.235), whereas survival rates were significantly higher in SLE/PH- in log-rank tests (p = 0.001). In multivariate analysis, the adjusted mortality hazard ratio (HR) for SLE/PH+ patients was 3.10. Subgroup analysis demonstrated a higher percentage of lupus nephritis in the SLE/PH+ patients who died (p = 0.039) and low complement-3 levels (p = 0.007). In univariate analysis, the mortality HR for SLE/PH+ patients with lupus nephritis was 4.62, whereas the presence of RP decreased the mortality risk in multivariate analysis; adjusted HR, 0.10. CONCLUSIONS: PH is an independent factor predicting survival in SLE patients. The presence of lupus nephritis resulted in an increased trend for mortality, whereas coexistence of RP was associated with a better survival prognosis in SLE/PH+ patients.
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spelling pubmed-43513312015-03-06 Pulmonary hypertension in systemic lupus erythematosus: an independent predictor of patient survival Min, Hong Ki Lee, Jae Ho Jung, Seung Min Lee, Jennifer Kang, Kwi Young Kwok, Seung-Ki Ju, Ji Hyeon Park, Kyung-Su Park, Sung-Hwan Korean J Intern Med Original Article BACKGROUND/AIMS: We investigated whether transthoracic echocardiography-suspected pulmonary hypertension (PH) affects survival in systemic lupus erythematosus (SLE) patients and examined factors associated with PH occurrence and survival. METHODS: This retrospective single-center study included 154 Korean SLE patients fulfilling the American College of Rheumatology criteria (January 1995 to June 2013). Student t test, Mann-Whitney U test, Kaplan-Meier curves, and log-rank tests were used for comparisons. RESULTS: A total of 35 SLE patients with PH (SLE/PH+) and 119 without PH (SLE/PH-) were analyzed. Higher percentages of interstitial lung disease, Raynaud's phenomenon (RP), World Health Organization functional classification III/IV, and cardiomegaly were found in SLE/PH+ compared to SLE/PH-. Furthermore, the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index was significantly higher in SLE/PH+ (2.46 ± 1.245 vs. 1.00 ± 1.235), whereas survival rates were significantly higher in SLE/PH- in log-rank tests (p = 0.001). In multivariate analysis, the adjusted mortality hazard ratio (HR) for SLE/PH+ patients was 3.10. Subgroup analysis demonstrated a higher percentage of lupus nephritis in the SLE/PH+ patients who died (p = 0.039) and low complement-3 levels (p = 0.007). In univariate analysis, the mortality HR for SLE/PH+ patients with lupus nephritis was 4.62, whereas the presence of RP decreased the mortality risk in multivariate analysis; adjusted HR, 0.10. CONCLUSIONS: PH is an independent factor predicting survival in SLE patients. The presence of lupus nephritis resulted in an increased trend for mortality, whereas coexistence of RP was associated with a better survival prognosis in SLE/PH+ patients. The Korean Association of Internal Medicine 2015-03 2015-02-27 /pmc/articles/PMC4351331/ /pubmed/25750566 http://dx.doi.org/10.3904/kjim.2015.30.2.232 Text en Copyright © 2015 The Korean Association of Internal Medicine http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Min, Hong Ki
Lee, Jae Ho
Jung, Seung Min
Lee, Jennifer
Kang, Kwi Young
Kwok, Seung-Ki
Ju, Ji Hyeon
Park, Kyung-Su
Park, Sung-Hwan
Pulmonary hypertension in systemic lupus erythematosus: an independent predictor of patient survival
title Pulmonary hypertension in systemic lupus erythematosus: an independent predictor of patient survival
title_full Pulmonary hypertension in systemic lupus erythematosus: an independent predictor of patient survival
title_fullStr Pulmonary hypertension in systemic lupus erythematosus: an independent predictor of patient survival
title_full_unstemmed Pulmonary hypertension in systemic lupus erythematosus: an independent predictor of patient survival
title_short Pulmonary hypertension in systemic lupus erythematosus: an independent predictor of patient survival
title_sort pulmonary hypertension in systemic lupus erythematosus: an independent predictor of patient survival
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4351331/
https://www.ncbi.nlm.nih.gov/pubmed/25750566
http://dx.doi.org/10.3904/kjim.2015.30.2.232
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